Georgiou Areti, Iatridi Fotini, Karpetas Antonios, Theodorakopoulou Marieta P
First Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Therapeutiki Hemodialysis Unit, Thessaloniki, Greece.
Clin Hypertens. 2025 Apr 1;31:e14. doi: 10.5646/ch.2025.31.e14. eCollection 2025.
We read with interest the study by Han et al., offering important insights into the associations between different levels of physical and muscle-strengthening activities and chronic kidney disease (CKD) prevalence in hypertensive patients in Korea. However, when reading the paper, we noticed some issues that warrant discussion. First and most important one, the definition used for CKD is incomplete as the authors define CKD solely based on a single measurement of eGFR < 60 mL/min/1.73 m, neglecting other essential components of the CKD definition and therefore, misdiagnose CKD in several circumstances. This has likely led to misclassification of cases and underestimation of the true prevalence of CKD. Additionally, characteristics of residential environment as an independent variable, which have been reported by recent studies to be the only factors strongly associated with CKD patients' physical activity, were not considered in the analysis. Finally, the assessment of physical and muscle-strengthening activity relied only on self-reported questionnaires, which may have introduced recall biases and misclassification of activity levels. Overall, although novel, the observed findings need to be confirmed by future, larger and optimally designed studies.
我们饶有兴趣地阅读了Han等人的研究，该研究为韩国高血压患者不同水平的体力活动和肌肉强化活动与慢性肾脏病（CKD）患病率之间的关联提供了重要见解。然而，在阅读该论文时，我们注意到一些值得讨论的问题。首先也是最重要的一点，用于定义CKD的标准不完整，因为作者仅基于估算肾小球滤过率（eGFR）<60 mL/min/1.73 m²的单次测量来定义CKD，而忽略了CKD定义中的其他重要组成部分，因此在某些情况下会误诊CKD。这很可能导致病例分类错误，并低估了CKD的真实患病率。此外，分析中未考虑居住环境特征这一自变量，最近的研究表明，居住环境特征是与CKD患者体力活动密切相关的唯一因素。最后，对体力活动和肌肉强化活动的评估仅依赖于自我报告的问卷，这可能会引入回忆偏倚和活动水平的分类错误。总体而言，尽管该研究具有创新性，但观察到的结果需要未来更大规模且设计优化的研究来证实。
